Low Fertility And Reproductive Health In East Asia

This book provides a unique blend of social and biomedical sciences in the field of low fertility and reproductive health. It offers a significant contribution to understanding the determinants of low fertility mostly in East Asia, including an assessment of the effectiveness of policies that aim to raise fertility. It introduces new analytical tools and methods and shares application of innovative approaches to analyzing cross-sectional and longitudinal survey data and macro socioeconomic data to shed light on changing mechanisms of low fertility in the context of reproductive health. The volume introduces the demographic dividend into the study of fertility, analyzes possible impact of population ageing on the amount of resources allocated to child rearing, i.e. the so called "crowding effect" in social care and public spending between the elderly and children. The book also tests the Low Fertility Trap (LFT) hypothesis, a new important theory regarding fertility trends. The book focuses on East Asia which is numerically large but relatively under-researched with regard to issues covered in various chapters. The relevance of the volume, however, goes beyond countries in East Asia. The book breaks new grounds and reveals little known facts regarding the influence of endocrine disruptors on male fertility through falling sperm counts, the phenomenon of marital sexlessness and about the sexual behavior of adolescents in East Asia.

This book brings together work on the low fertility countries of East Asia with an analysis of trends in fertility, what we know about their determinants and consequences, the policy issues and how these are being addressed in the various countries.

This book examines the trends, underlying factors, and policy implications of fertility declines in three East Asian countries: Japan, South Korea, and China. In contrast to Western countries that have also experienced fertility declines to below-replacement levels, fertility decline in these East Asian countries is most notable in its rapidity and sheer magnitude. After a rapid decline shortly after the war, in which fertility was halved in one decade from 4.5 children per woman in 1947 to 2.1 in 1957, Japan's fertility started to decline to below-replacement levels in the mid-1970s, reaching 1.3 per woman in the early 2000s. Korea experienced one of the most spectacular declines ever recorded, with fertility falling continuously from very high (6.0 per woman) to a below-replacement level (1.6 per woman) between the early 1960s and mid-1980s, reaching 1.1 per woman in 2005. Similarly, after a dramatic decline from very high to low levels in one decade from the early 1970s to early 1980s, China's fertility reached around 1.5 per woman by 2005. Despite differences in timing, tempo, and scale of fertility declines, dramatic fertility reductions have resulted in extremely rapid population aging and foreshadow a long-term population decline in all three countries. This monograph provides a systematic comparison of fertility transitions in these East Asian countries and discusses the economic, social, and cultural factors that may account for their similarities and differences. After an overview of cultural backgrounds, economic transformations, and the evolution of policies, the trends and age patterns of fertility are examined. The authors then investigate changes in women's marriage and childbearing within marriage, the two major direct determinants of fertility, followed by an analysis of the social and economic factors underlying fertility and nuptiality changes, such as education, women's employment, and gender relations at home.

This groundbreaking volume captures and analyzes the exhilarating and at times disorienting experience when scientists, government officials, educators, and the general public in East Asia tried to come to terms with the introduction of Western biological and medical sciences to the region. The nexus of gender and health is a compelling theme, for this is an area in which private lives and personal characteristics encounter the interventions of public policies. The nine empirically based studies by scholars of history of medicine, sociology, anthropology, and STS (science, technology, and society), spanning Japan, Korea, China, Taiwan, and Hong Kong from the 1870s to the present, demonstrate just how tightly concerns with gender and health have been woven into the enterprise of modernization and nation-building throughout the long twentieth century. The concepts of “gender” and “health” have become so commonly used that one might overlook that they are actually complicated notions with vexed histories even in their native contexts. Transposing such terminologies into another historical or geographical dimension is fraught with problems, and what makes the East Asian cases in this volume particularly illuminating is that they present concepts of gender and health in motion. The studies show how individuals and societies made sense of modern scientific discourses on diseases, body, sex, and reproduction, redefining existing terms in the process and adopting novel ideas to face new challenges and demands. “Whether reviewing the comparative national histories of birth control, debating early cases of transsexual surgery, or highlighting the resurgence of ‘traditional’ Asian medical commodities, this volume provides accessible and productive studies on these intriguing topics in Asia. Scholars of modern East Asia and indeed anyone concerned with the analysis of gender and health in light of intersecting postcolonial studies will find the book rewarding.” —Rayna Rapp, New York University “A bold and important volume that explores the interweaving of gender, body, and modernity throughout East Asia. With vivid articles on sexuality, reproductive technologies, and sexual identities, the book opens multiple possibilities for how ‘Asia as method’ can shine new light on persistent theoretical questions from biopower to biocitizenship.” —Ruth Rogaski, Vanderbilt University

Sexually transmitted diseases, unintended pregnancies, infertility, and other reproductive problems are a growing concern around the world, especially in developing countries. Reproductive Health in Developing Countries describes the magnitude of these problems and what is known about the effectiveness of interventions in the following areas: Infection-free sex. Immediate priorities for combating sexually transmitted and reproductive tract diseases are identified. Intended pregnancies and births. The panel reports on the state of family planning and ways to provide services. Healthy pregnancy and delivery. The book explores the myths and substantive socio-economic problems that underlie maternal deaths. Healthy sexuality. Such issues as sexual violence and the practice of female genital mutilation are discussed in terms of the cultural contexts in which they occur. Addressing the design and delivery of reproductive health services, this volume presents lessons learned from past programs and offers principles for deciding how to spend limited available funds. Reproductive Health in Developing Countries will be of special interest to policymakers, health care professionals, and researchers working on reproductive issues in the developing world.

The evaluation of reproductive, maternal, newborn, and child health (RMNCH) by the Disease Control Priorities, Third Edition (DCP3) focuses on maternal conditions, childhood illness, and malnutrition. Specifically, the chapters address acute illness and undernutrition in children, principally under age 5. It also covers maternal mortality, morbidity, stillbirth, and influences to pregnancy and pre-pregnancy. Volume 3 focuses on developments since the publication of DCP2 and will also include the transition to older childhood, in particular, the overlap and commonality with the child development volume. The DCP3 evaluation of these conditions produced three key findings: 1. There is significant difficulty in measuring the burden of key conditions such as unintended pregnancy, unsafe abortion, nonsexually transmitted infections, infertility, and violence against women. 2. Investments in the continuum of care can have significant returns for improved and equitable access, health, poverty, and health systems. 3. There is a large difference in how RMNCH conditions affect different income groups; investments in RMNCH can lessen the disparity in terms of both health and financial risk.

These four papers supplement the book Contraception and Reproduction: Health Consequences for Women and Children in the Developing World by bringing together data and analyses that would otherwise be difficult to obtain in a single source. The topics addressed are an analysis of the relationship between maternal mortality and changing reproductive patterns; the risks and benefits of contraception; the effects of changing reproductive patterns on infant health; and the psychosocial consequences to women of controlled fertility and contraceptive use.

This volume examines two distinct low fertility scenarios that have emerged in economically advanced countries since the turn of the 20th century: one in which fertility is at or near replacement-level and the other where fertility is well below replacement. It explores the way various institutions, histories and cultures influence fertility in a diverse range of countries in Asia, Europe, North America and Australia. The book features invited papers from the Conference on Low Fertility, Population Aging and Population Policy, held December 2013 and co-sponsored by the East-West Center and the Korea Institute for Health and Social Affairs (KIHASA). It first presents an overview of the demographic and policy implications of the two low fertility scenarios. Next, the book explores five countries currently experiencing low fertility rates: China, Hong Kong, Japan, Singapore and South Korea. It then examines three countries that have close to replacement-level fertility: Australia, the Netherlands and the United States. Each country is featured in a separate chapter written by a demographer with expert knowledge in the area. Very low fertility is linked to a number of conditions countries face, including a declining population size. At the same time, low fertility and its effect on the age structure, threatens social welfare policies. This book goes beyond the technical to examine the core institutional, policy and cultural factors behind this increasingly important issue. It helps readers to make cross-country comparisons and gain insight into how diverse institutions, policies and culture shape fertility levels and patterns.